| 11/07/2012 |
| 08:33:03 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| PEREZ, MARGO, | 4B-000725 | R | 29.00 | 4356********0528 | 101708 | 11/07/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 29.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 29.00 |